Healthcare Provider Details

I. General information

NPI: 1073848701
Provider Name (Legal Business Name): AAMNAH HUSAIN M.A., EDM., MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 10/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 EVANS AVE OUTPATIENT SERVICES
SAN FRANCISCO CA
94124-1430
US

IV. Provider business mailing address

1550 EVANS AVE OUTPATIENT SERVICES
SAN FRANCISCO CA
94124-1430
US

V. Phone/Fax

Practice location:
  • Phone: 415-970-7604
  • Fax: 415-970-7575
Mailing address:
  • Phone: 415-970-7604
  • Fax: 415-970-7575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: